Naila Iftikhar, Tahira Batool.
Comparison of the effects of clomiphene citrate alone versus combined metformin and clomiphene citrate in increasing ovulation and fertility in patients with polycystic ovarian syndrome with anovulatory infertility.
Isra Med J Jan ;6(1):15-8.

OBJECTIVES: To evaluate the effects of clomiphene citrate alone versus combined metformin and clomiphene citrate in patients of polycystic ovarian syndrome with anovulatory infertility in increasing ovulation and pregnancy rate. STUDY DESIGN: A Randomized controlled study. PLACE AND DURATION: The study was done at the infertility clinic of Gynaecology and Obstetrics dept of KRL hospital Islamabad for one year from 16th November, 2009 till 15th November, 2010. METHODOLOGY: 74 diagnosed patients of PCOS with anovulatory infertility were included in the study. Simple random sampling was done and 37 patients of group A were given clomiphene citrate from 50-150 mg on 2nd – 6th day of menstrual cycle, for 6 cycles. The patients of group B were given Metformin 1.5 gms daily for 6 months alongwith clomiphene citrate 50-150 mg on 2nd -6th day of menstrual period, maximum 6 cycles. Ovulation was monitored by transvaginal sonography and serum progesterone level measurement which was done on 21st day of the cycle. Pregnancy was confirmed by serum B-hCG. RESULTS: The analysis showed that the ovulation was significantly higher (78%, 29/37) in group B as compared to group A (40.54%, 15/37), (P-value 0.001) in group B as compared to group A. Similarly the pregnancy rate was also significantly higher in group B i.e 62.16% (23/37) vs. 24.32% (9/37), P-value 0.001) as compared to group A. CONCLUSION: The results proved that metformin along with clomiphene citrate significantly improves ovulation and pregnancy rate in patients of PCOS with anovulatory infertility and the combination of both drugs produced far better results than clomiphene citrate alone.

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